Published byStanford Medicine

The story of Anabel Stenzel and Isabel Stenzel Byrnes, twins born with cystic fibrosis, is now getting the silver screen (or liquid crystal, if you prefer) treatment. A film based on their memoir releases digitally in the U.S. today.

The half-Japanese sisters graduated from Stanford in 1994 and now work at Lucile Packard Children’s Hospital. As advocates for organ donation, they travel and tell the story of how lung transplants changed their lives. The film revolves around the twins’ speaking tour in Japan, where attitudes toward organ donation are vastly different from here in the U.S.

Producer Andrew Byrnes knew of the story because he was closely connected to Isa: The two met at Stanford and are married. “When we first met I knew nothing about cystic fibrosis and transplant,” Byrnes says. “But the twins – who they are and what they have done – has been an inspiration. Sharing that with the world is something that is important to me.”

Byrnes originally approached filmmaker Marc Smolowitz to ask if the Academy-award nominated director knew anyone who might record the twins’ speeches in Japan. Smolowitz read the book and was captivated. “I read fell in love with Ana and Isa as writers and characters,” he says.

In the following Q&A, Smolowitz and Byrnes discuss the message and making of the film.

What was it like working with the sisters?

Smolowitz: It was an a amazing collaboration. They are both writers and storytellers and I am a storyteller. We worked very closely together and I brought them into the process. We mapped their itinerary–where do they go throughout the year as they do their work as organ donation advocates. When you focus so closely on two people such as Ana and Isa you are really building on their credibility. Ana and Isa are well-loved by the people that know them and the work they do.

Did anything surprising or unexpected come out of the collaboration?

Smolowitz: I guess the most surprising moment in production was right at the start of editing. I had just hired the editors and we spent the weekend giving them a chance to know Ana and Isa. We visited both of their houses. I had always known that the twins were very active with scrapbooks, photo albums and journals, but I hadn’t realized the extent of it. They have hundreds of volumes of diaries, journals, scrapbooks and photo albums that they’ve made–just physical evidence that they have lived. It’s like a lightbulb went off for me. These girls had to keep these journals because they had to record their lives. They had to show that they had lived. When you see the movie you realize it is all kind of wrapped around this photographic world.

Was there a part of the story that was really challenging?

Smolowitz: The books had been written before we went to Japan so everything there was being told for the first time. I decided to take a very humanistic approach to understand organ donation and the Japanese culture. There is no good or bad here; there is just different.

Byrnes: We shot in 27 cities and three countries, so part of the challenge was getting everyone to those places. Whenever you do a film about health issues with patients, there is concern about how their health will change during filming. We’ve been blessed that Ana and Isa have been in good health not only during the film but during the release. Audiences like seeing the film, but they especially like seeing the twins in person.

What message did you want to convey in the film?

Byrnes: When we started with the project we really were thinking thematically not just about the film but also about the larger movement around the film about organ donation and transplantation. We arrived at the phrase “There’s a miracle in every breath.” To me that really encapsulates what the film is all about, both because of the twins’ specific story – their, in my view, miraculous transplants that allowed them to live longer than anyone expected – but also because it speaks to all of us who often goes through life without being aware of breath. I think the film really makes the view stand back and realize this is something spectacular and miraculous and I shouldn’t take it for granted.

How have audiences reacted to the film so far?

Byrnes: Audiences have been just ecstatic about the film. We’ve been to over 30 film festivals around the world and the response has been very positive.

Smolowitz: It plays beautifully to audiences. It moves people. Part of what I set out to do was not just make you cry but make you feel. When you are a filmmaker, you try to connect with your audiences in a number of ways. I refer to it as the head, the heart and the gut. I try to make you think, I try to make you feel and I try to surprise and delight you. The way the movie is edited, the pacing through this journey of illness and transplant, its a very emotional journey.

We’ve had standing ovations, afterward people have run up and hug us and talk to us and want to understand more. No one movie can be all things for all people, but it can certainly start a conversation. I think “The Power of Two” has started a really interesting conversation about organ donation.